| NPI | 1396285466 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 296625) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9328002) | 
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9328002) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 11978) | |
| Enumeration Date | 2017-03-08 | 
| Last Update Date | 2023-06-22 |